<!--
  ========================LICENSE_START=================================
  screenit-web
  %%
  Copyright (C) 2012 - 2020 Facilitaire Samenwerking Bevolkingsonderzoek
  %%
  This program is free software: you can redistribute it and/or modify
  it under the terms of the GNU Affero General Public License as published by
  the Free Software Foundation, either version 3 of the License, or
  (at your option) any later version.
  
  This program is distributed in the hope that it will be useful,
  but WITHOUT ANY WARRANTY; without even the implied warranty of
  MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  GNU General Public License for more details.
  
  You should have received a copy of the GNU Affero General Public License
  along with this program.  If not, see <http://www.gnu.org/licenses/>.
  =========================LICENSE_END==================================
  -->
<html xmlns:wicket="http://wicket.apache.org">
<wicket:panel>
    <div class="modal-header">
        <button type="button" class="close" wicket:id="close">&times;</button>
        <h3>Blokkade toevoegen</h3>
    </div>
    <form wicket:id="form" class="form-horizontal">
        <div class="modal-body">
            <div class="control-group">
                <label class="control-label">Type</label>
                <div class="controls">
                    <select wicket:id="type"/>
                </div>
            </div>
            <div class="control-group" wicket:id="regioContainer">
                <label class="control-label">Screeningsorganisatie</label>
                <div class="controls">
                    <strong wicket:id="regio.naam"/>
                </div>
            </div>
            <div class="control-group" wicket:id="screeningsEenheidContainer">
                <label class="control-label">Screeningseenheid</label>
                <div class="controls">
                    <select wicket:id="screeningsEenheid"/>
                    <strong wicket:id="screeningsEenheid.naam"/>
                </div>
            </div>
            <div class="control-group" wicket:id="standplaatsContainer">
                <label class="control-label">Standplaats</label>
                <div class="controls">
                    <select wicket:id="standplaats"/>
                </div>
            </div>
            <div class="control-group">
                <label class="control-label">Vanaf / tot en met</label>
                <div class="controls">
                    <div class="input-append">
                        <input type="text" class="datum" wicket:id="vanaf"/>
                        <a href="javascript:void(0);" class="btn" onclick="$(this).prev().datepicker('show');">
                            <i class="icon-calendar"/>
                        </a>
                    </div>
                    <div class="input-append">
                        <input type="text" class="datum" wicket:id="totEnMet"/>
                        <a href="javascript:void(0);" class="btn" onclick="$(this).prev().datepicker('show');">
                            <i class="icon-calendar"/>
                        </a>
                    </div>
                </div>
            </div>
            <div class="control-group">
                <label class="control-label">Reden</label>
                <div class="controls">
                    <textarea style="width: 95%; resize: none;" wicket:id="reden"/>
                </div>
            </div>
        </div>
        <div class="modal-footer">
            <button class="btn btn-primary right" wicket:id="opslaan" type="button">Opslaan</button>
            <button wicket:id="inActiveren" class="btn right" type="button">
                <span class="icon-minus-sign"/> <span wicket:id="inActiverenLabel"/>
            </button>
        </div>
    </form>
    <div wicket:id="dialog"></div>
</wicket:panel>
</html>
